scholarly journals What Are Staff Perceptions About Their Current Use of Emergency Departments for Long-Term Care Residents at End of Life?

2017 ◽  
Vol 28 (6) ◽  
pp. 692-707 ◽  
Author(s):  
Sharon Kaasalainen ◽  
Tamara Sussman ◽  
Pamela Durepos ◽  
Lynn McCleary ◽  
Jenny Ploeg ◽  
...  
Keyword(s):  
End Of Life ◽  
Long Term Care ◽  
Hospital Staff ◽  
Clinical Expertise ◽  
Staff Perceptions ◽  
Term Care ◽  
Reflective Process ◽  
Hospital Deaths ◽  
Chart Audits

The goal of this study was to examine current rates of resident deaths, Emergency Department (ED) use within the last year of life, and hospital deaths for long-term care (LTC) residents. Using a mixed-methods approach, we compared these rates across four LTC homes in Ontario, Canada, and explored potential explanations of variations across homes to stimulate staff reflections and improve performance based on a quality improvement approach. Chart audits revealed that 59% of residents across sites visited EDs during the last month of life and 26% of resident deaths occurred in hospital. Staff expressed surprise at the amount of hospital use during end of life (EOL). Reflections suggested that clinical expertise, comfort with EOL communication, clinical resources (i.e., equipment), and family availability for EOL decision making could all affect nondesirable hospital transfers at EOL. Staff appeared motivated to address these areas of practice following this reflective process.

scholarly journals Condition-Specific Pamphlets to Improve End-of-life Communication in Long-term Care: Staff Perceptions on Usability and Use

2019 ◽  
Vol 20 (3) ◽  
pp. 262-267 ◽  
Author(s):  
Tamara Sussman ◽  
Sharon Kaasalainen ◽  
Eunyoung Lee ◽  
Noori Akhtar-Danesh ◽  
Patricia H. Strachan ◽  
...  
Keyword(s):  
End Of Life ◽  
Long Term Care ◽  
Care Staff ◽  
Staff Perceptions ◽  
Term Care ◽  
End Of Life Communication

scholarly journals REDUCING EMERGENCY ROOM VISITS AND HOSPITAL DEATHS AT END-OF-LIFE FOR LONG-TERM CARE RESIDENTS

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 508-509
Author(s):  
S. Kaasalainen ◽  
T. Sussman ◽  
P. Durepos ◽  
J. Ploeg ◽  
L. Venturato ◽  
...  
Keyword(s):  
Emergency Room ◽  
End Of Life ◽  
Long Term Care ◽  
Emergency Room Visits ◽  
Term Care ◽  
Hospital Deaths

Staff Perceptions of End-of-Life Care in Long-Term Care

2003 ◽  
Vol 4 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Sheryl Zimmerman ◽  
Philip D. Sloane ◽  
Laura Hanson ◽  
C. Madeline Mitchell ◽  
Ann Shy
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Life Care ◽  
Staff Perceptions ◽  
Term Care

scholarly journals Evaluation of a Program Based on the Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) Model

2019 ◽  
Author(s):  
Sharon Kaasalainen ◽  
Tamara Sussman ◽  
Genevieve Thompson ◽  
Lynn McCleary ◽  
Paulette Hunter ◽  
...  
Keyword(s):  
End Of Life ◽  
Family Involvement ◽  
Long Term Care ◽  
Staff Support ◽  
Term Care ◽  
Palliative Approach ◽  
Study Results ◽  
Planning Methods ◽  
Hospital Deaths

Abstract Background: Despite increased annual mortality in long-term care (LTC) homes, research has shown that palliative approaches to care are currently suboptimal in these settings. The purpose of this study was to evaluate resident, family, and staff outcomes associated with the Strengthening a Palliative Approach in LTC (SPA-LTC) program, developed to help encourage meaningful end-of-life discussions and planning. Methods: The study employs a mixed method design in four LTC homes across Southern Ontario. Data were collected from residents, families and staff of the LTC homes through chart reviews, surveys and interviews. Results: In total, 39 residents/families agreed to participate in the study. Positive intervention outcomes included a reduction in the proportion of emergency department use at end-of-life and hospital deaths for those participating in SPA-LTC, an improvement in interdisciplinary communication between staff, support for both families and staff involved, and increased family involvement in the care of residents. However, there were no significant pre-post differences in staff collaboration or comfort in providing end of life care. Conclusions: The benefits of SPA-LTC for families, residents and staff justify its continued use within LTC. Study results also suggest that certain enhancements of the program could further promote future integration of best practices within a palliative approach to care within the LTC context.

scholarly journals Cost of shifting from healthcare to long-term care in later life across major diseases: analysis of end-of-life care during the last 24 months of life

2018 ◽  
Vol 13 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Tomoko Terada ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Masashi Kizuki ◽  
Naohiko Inase
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Later Life ◽  
Life Care ◽  
Term Care

scholarly journals END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
Kelly Shryock ◽  
Jacinta Dickens ◽  
Anisha Thomas ◽  
Suzanne Meeks
Keyword(s):  
Quality Of Life ◽  
Positive Affect ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Well Being ◽  
Life Care ◽  
Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

scholarly journals First-Dose Coronavirus 2019 Vaccination Coverage among the Residents of Long-Term Care Facilities in France

Gerontology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Joël Belmin ◽  
Pierre Lutzler ◽  
Patrick Hidoux ◽  
Olivier Drunat ◽  
Carmelo Lafuente-Lafuente ◽  
...  
Keyword(s):  
End Of Life ◽  
Vaccination Coverage ◽  
Long Term Care ◽  
Vaccination Campaign ◽  
Coverage Rate ◽  
Life Situation ◽  
Term Care ◽  
Care Facilities ◽  
History Of

<b><i>Background:</i></b> Long-term care facilities (LTCFs) experienced severe burden from the Coronavirus 2019 (COVID-19), and vaccination against SARS-CoV-2 is a major issue for their residents. <b><i>Objective:</i></b> The objective of this study was to estimate the vaccination coverage rate among the residents of French LTCFs. <b><i>Method:</i></b> Participants and settings: 53 medical coordinators surveyed 73 LTCFs during the first-dose vaccination campaign using the BNT162b2 vaccine, conducted by health authorities in January and early February 2021. Measurements: in all the residents being in the LTCF at the beginning of the campaign, investigators recorded age, sex, history of clinical or asymptomatic COVID-19, serology for SARS-CoV-2 or severe allergy, current end-of-life situation, infectious or acute disease, refusal of vaccination by the resident or by the representative person of vaccine, and the final status, vaccinated or not. <b><i>Results:</i></b> Among the 4,808 residents, the average coverage rate for COVID-19 vaccination was 69%, and 46% of the LTCFs had a coverage rate &#x3c;70%. Among unvaccinated residents, we observed more frequently a history of COVID-19 or a positive serology for SARS-CoV-2 (44.6 vs. 11.2% among vaccinated residents, <i>p</i> &#x3c; 0.001), a history of severe allergy (3.7 vs. 0.1%, <i>p</i> &#x3c; 0.001), end-of-life situation (4.9 vs. 0.3%, <i>p</i> &#x3c; 0.001), current infectious or acute illness (19.6 vs. 0.3%, <i>p</i> &#x3c; 0.001), and refusal of vaccination by residents or representative persons (38.9 vs. 0.4%, <i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> About 3 out of 10 residents remained unvaccinated, and half of the LTCFs had a coverage rate &#x3c;70%. This suggests that COVID-19 will remain a threat to many LTCFs after the vaccination campaigns.

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